Iyizoba-Ebozue, Z, Murray, LJ orcid.org/0000-0003-0658-6455, Arunsingh, M et al. (3 more authors) (2020) Incidence and patterns of retropharyngeal lymph node involvement in oropharyngeal carcinoma. Radiotherapy and Oncology, 142. pp. 92-99. ISSN 0167-8140
Abstract
Introduction:
The aim was to evaluate in oropharyngeal carcinoma the: (1) incidence and predictors of retropharyngeal (RP) lymph node (LN) involvement, (2) pattern of ipsilateral/bilateral/contralateral-only RP LNs (3) location of RP LNs in relation to contouring guidelines.
Methods:
Single centre retrospective analysis of 402 patients with oropharyngeal carcinoma treated non-surgically between 2010 and 2017. All patients had a baseline FDG PET-CT and contrast-enhanced MRI and/or CT. All cases with reported abnormal RP LNs underwent radiology review.
Results:
Abnormal RP LNs were identified in 40/402 (10%) of patients. On multivariate analysis, RP LN involvement was associated with posterior pharyngeal wall/soft palate primaries (OR 10.13 (95% CI 2.29–19.08), p = 0.002) and contralateral cervical LN involvement (OR 2.26 (95% CI 1.05–4.86), p = 0.036). T stage, largest LN size, levels of ipsilateral LN level involvement, HPV and smoking status did not predict risk. 5/402 (1.2%) patients had bilateral RP involvement. 3/402 patients (0.7%) had contralateral-only RP LNs. All patients with contralateral RP LNs had contralateral neck nodes or primary cancers extending across midline. In 5/40 (12.5%) cases with involved RP LNs, the RP LNs were superior to hard palate/upper edge of body of C1 vertebra.
Conclusions:
RP LNs were identified in 10% of oropharyngeal carcinoma patients, and were associated with contralateral neck disease and/or posterior pharyngeal wall/soft palate primary. Contralateral RP LN involvement was rare and associated with contralateral neck disease and/or primary crossing midline, suggesting potential for omission from target volumes for selected patients. Involvement of RP LNs close to the skull base highlights the need for generous elective outlining.
Metadata
Item Type: | Article |
---|---|
Authors/Creators: |
|
Copyright, Publisher and Additional Information: | © 2019, Elsevier BV. All rights reserved. This is an author produced version of an article published in Radiotherapy and Oncology. Uploaded in accordance with the publisher's self-archiving policy. |
Keywords: | Oropharyngeal cancer; Retropharyngeal lymph nodes; Radiotherapy; PET-CT |
Dates: |
|
Institution: | The University of Leeds |
Academic Units: | The University of Leeds > Faculty of Medicine and Health (Leeds) > School of Medicine (Leeds) > Inst of Biomed & Clin Sciences (LIBACS) (Leeds) |
Depositing User: | Symplectic Publications |
Date Deposited: | 02 Sep 2019 10:04 |
Last Modified: | 01 Sep 2020 00:38 |
Status: | Published |
Publisher: | Elsevier |
Identification Number: | 10.1016/j.radonc.2019.07.021 |
Open Archives Initiative ID (OAI ID): | oai:eprints.whiterose.ac.uk:150241 |
Downloads
Filename: RPLN v1.6 26062019 no track.pdf
Licence: CC-BY-NC-ND 4.0
Filename: Table1 26062019.pdf
Licence: CC-BY-NC-ND 4.0
Filename: Table2 19032019.pdf
Licence: CC-BY-NC-ND 4.0
Filename: Table3 13032019.pdf
Licence: CC-BY-NC-ND 4.0
Filename: Table 4 26062019.pdf
Licence: CC-BY-NC-ND 4.0
Filename: Figure1 600dpi.png
Licence: CC-BY-NC-ND 4.0
Filename: Figure2 600dpi.png
Licence: CC-BY-NC-ND 4.0